This disclosure relates generally to clinical workflow, and more particularly to a design of a device configured to aid in enhancing clinical workflow.
In a caregiving facility, such as a hospital, and more particularly, in an Intensive Care Unit (ICU), it may be desirable to provide artificial ventilation to one or more patients. As will be appreciated, patients in the ICU that have been identified as needing artificial ventilation are typically intubated and ventilated in order to treat and manage respiratory failures, such as asthma, pneumonia, pulmonary edema, pulmonary embolism, chronic bronchitis, post-operative hypoxemia, chest injuries and chronic lung disease. Along with patients suffering from respiratory failure, certain patients may need ventilatory support for other medical reasons. By way of example, post-operative ICU patients and certain maxillofacial surgical patients may also require a period of post operative care in the ICU, during which time the patients are typically kept sedated and ventilated.
Traditionally, artificial ventilation is provided via use of a ventilator. More particularly, artificial ventilation is provided via positive pressure ventilation, where gas is delivered under positive pressure, allowing alveoli expansion and gas exchange. Once a patient has been identified as needing artificial ventilation, they are intubated and placed on a ventilator and ventilated using positive pressure. Gases are delivered to the patient using pressure to inflate the lungs, expand the alveoli and allow for gas exchange and oxygenation. In other words, one of the goals of conventional artificial ventilation is to use positive pressure to deliver gas and achieve respective ventilatory goals.
However, the effects of this non-physiological approach to ventilation are numerous and can be detrimental. Furthermore, in diseased lungs, positive pressure ventilation may not always provide adequate carbon dioxide (CO2) clearance or oxygen delivery and may even result in alveolar and/or lung damage due to ventilating at high airway pressures. The other side effects of positive pressure ventilation may include decreased cardiac output, reduced venous return, decreased urine output, retention of fluids, risk of ventilator associated pneumonia, and risk of tracheal and lung damage if gases are not humidified.
An alternative approach to conventional ventilation has emerged over the last decade and is known as High Frequency Ventilation. It may be noted that High Frequency Ventilation may include High Frequency Oscillatory Ventilation (HFOV). Patients, who are at risk of further lung damage due to increases in airway pressure secondary to increases in resistance and decreases in compliance, may benefit from HFOV. In other words, when conventional ventilation fails to safely and adequately provide respiratory support, HFOV may be considered as an alternative method of ventilating the patient.
As will be appreciated, HFOV provides small tidal volumes usually equal to, or less than the dead space (e.g., about 2 ml/kg), at a very fast rate of between 5-15 breaths per second. The delivery of tidal volumes of dead space or less at very high frequencies enables the maintenance of a minute volume. Furthermore, lungs are kept open to a constant airway pressure via a mean pressure adjust system. Also, HFOV advantageously allows for the decoupling of oxygenation from ventilation as HFOV allows the clinician to separately adjust either oxygenation or ventilation.
As noted hereinabove, HFOV is a specialized form of ventilation considered to be part of a lung protective strategy to ventilate a patient with damaged lungs. HFOV has traditionally been applied through the use of a device separate from the ICU ventilator, where the ICU ventilator is typically used to assist patients that are unable to breathe on their own. However, use of the standalone HFOV ventilator has huge cost implications. Moreover, a transition between normal ventilation via use of the ICU ventilator and HFOV via the HFOV ventilator may unfortunately result in loss of pressure in the lungs of the patient, thereby causing discomfort to the patient. Moreover, there are equipment, time, and training issues associated with having the HFOV function separate from the ICU ventilator.
It may therefore be desirable to develop a design of a system that may be configured to advantageously aid the ICU ventilator in performing HFOV, thereby enhancing the clinical workflow by reducing equipment size, time to apply HFOV and reducing cost. More particularly, it may be desirable to provide seamless transition between normal ICU ventilation and HFOV, thereby preventing loss of circuit pressure during the transition and minimizing discomfort to the patient.